TUESDAY, Nov. 17 (HealthDay News) -- In patients undergoing percutaneous coronary intervention (PCI), the use of cangrelor is not superior to the use of clopidogrel or placebo, according to two studies published online Nov. 15 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions, held from Nov. 14 to 18 in Orlando, Fla.

Deepak L. Bhatt, M.D., of the VA Boston Healthcare System, and colleagues randomly assigned 5,362 patients who had not been treated with clopidogrel to receive either cangrelor or placebo during PCI followed by 600 mg of clopidogrel. At 48 hours, they found no significant difference between cangrelor and placebo in the primary end point: a composite of death, myocardial infarction, or ischemia-driven revascularization (7 versus 8 percent).

Robert A. Harrington, M.D., of the Duke University Medical Center in Durham, N.C., and colleagues randomly assigned 8,716 patients undergoing PCI to receive either cangrelor or clopidogrel. At 48 hours, they found no significant difference between cangrelor and clopidogrel in the primary end point: a composite of death from any cause, myocardial infarction, or ischemia-driven revascularization (7.5 versus 7.1 percent).

"Minor bleeding was more common in patients who received cangrelor, and one measure of major bleeding (based on criteria from the ACUITY trial) showed a trend toward an increase in bleeding with cangrelor as compared with clopidogrel," Harrington and colleagues write. "Post hoc secondary analyses raise the possibility that further clinical investigation of cangrelor may be worthwhile."

Both studies were supported by the Medicines Company; several authors reported financial relationships with it and other pharmaceutical companies.

Abstract - Bhatt
Full Text
Abstract - Harrington
Full Text
More Information - AHA